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    v1.0.30
    OpenPayerBilling CodesTherapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration)CPT cpt-96373-arterial-medication-administration
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    CPT 96373: Intra-arterial Medication Administration

    Medicare pays $21 and commercial payers pay $60 on average nationally for this procedure.

    CPT code 96373 describes administration of a medication or other substance via an artery for therapeutic, prophylactic, or diagnostic purposes; this is an intra-arterial medication administration procedure typically performed by a clinician in an outpatient interventional suite, hospital inpatient setting, or specialized catheterization lab and is a vascular-directed parenteral service involving arterial access and drug delivery.

    For related coverage guidance, see recent payer policy updates: Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Esophagogastroduodenoscopy (EGD) Coverage Policy, Radiofrequency Therapy for Fecal Incontinence.

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    National Reimbursement Benchmarks

    Across national payers, Medicare’s mean rate of $20.50 for CPT 96373 sits considerably below the BUCA commercial average mean of $60.30, indicating a sizable gap between public reimbursement and that commercial cohort. Blue Cross Blue Shield and BUCA show the highest mean levels ($85.30 and $60.30 respectively), while Aetna and Medicare are clustered at lower means ($20.60 and $20.50), with Cigna and UnitedHealth Group in the $30 range. This highlights a clear separation between Medicare pricing and several commercial payers’ higher average reimbursements.

    Dispersion measured by the interquartile range (P75 minus P25) varies meaningfully: Blue Cross Blue Shield has the widest IQR at $48.30 (P75 $108.20 minus P25 $59.00), followed by UnitedHealth Group at $17.40, Cigna at $19.80, and BUCA at $33.00. Aetna exhibits the tightest spread with an IQR of $4.10. These differences suggest Blue Cross Blue Shield reimbursement is the most variable across geographies or contracts, while Aetna’s rates are relatively consistent.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with long-term medication needs (Z79.899), essential hypertension (I10), type 2 diabetes (E11.9), and chronic obstructive pulmonary disease (J44.9) presents to an outpatient vascular/interventional suite for an intra-arterial administration of medication to treat a localized vascular lesion. The patient reports worsening unilateral lower extremity ischemic pain and claudication despite medical therapy. After consultation with the interventionalist (family medicine or internal medicine clinician coordinating care, with a registered nurse assisting), the decision is made to perform intra-arterial administration of a vasodilator and diagnostic contrast injection to assess perfusion and relieve symptoms.

    The clinical workflow includes pre-procedure assessment (consent, allergies, medication reconciliation, and review of diabetes and hypertension control), vascular access via femoral or radial artery, selective catheterization of the target artery, intra-arterial medication administration, monitoring for hemodynamic or local vascular complications, and post-procedure observation with vital signs and access-site checks. Documentation includes indication, informed consent, artery accessed, medication name and dose, time of administration, patient response, and any complications. Billing uses 96373 for the intra-arterial administration; concurrent evaluation and management visits may use office visit codes when appropriate and separately reportable.

    Related CPT Codes

    CPT Code

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    163W00000X
    207Q00000X
    207R00000X
    261QI0500X
    332000000X
    163WC2100X
    261QA0900X
    207LP3000X

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Radiofrequency Therapy for Fecal IncontinenceCigna2026-10-15
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    High-Resolution Anoscopy (HRA)Premera Bluecross2026-10-01
    Gastroesophageal and Gastrointestinal (GI) Services and ProceduresColorado Rocky Mountain Health Plans2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01

    Related Codes

    CPT-96365-INITIAL-INTRAVENOUS-INFUSION-UP-TO-1-HOUR

    CPT 96365: Initial Intravenous Infusion, Up to 1 Hour

    CPT-96366-ADDITIONAL-HOUR-INTRAVENOUS-INFUSION

    CPT 96366: Additional Hour Intravenous Infusion

    CPT-96367-ADDITIONAL-INTRAVENOUS-INFUSION-DIFFERENT-SUBSTANCE-UP-TO-1-HOUR

    CPT 96367: Additional IV Infusion of Different Medication, Up to 1 Hour

    CPT-96368-CONCURRENT-INTRAVENOUS-INFUSION-MULTIPLE-MEDICATIONS

    CPT 96368: Concurrent Intravenous Infusion of Multiple Medications

    CPT-96369-SUBCUTANEOUS-INFUSION-SETUP-AND-ADMINISTRATION-UP-TO-1-HOUR

    CPT 96369: Infusion Pump Setup with Subcutaneous Port, Up to 1 Hour

    CPT-96370-SUBCUTANEOUS-INFUSION-ADDITIONAL-HOUR

    CPT 96370: Subcutaneous Infusion Per Additional Hour

    CPT-96371-SUBCUTANEOUS-PORT-SITE-ESTABLISHMENT-AND-INFUSION-PUMP-SETUP

    CPT 96371: Subcutaneous Port Relocation with Infusion Pump Administration

    CPT-96372-SUBCUTANEOUS-INTRAMUSCULAR-INJECTION-THERAPEUTIC-PROPHYLACTIC-DIAGNOSTIC

    CPT 96372: Intramuscular or Subcutaneous Therapeutic Injection

    CPT-96374-INTRAVENOUS-PUSH-SINGLE-MEDICATION

    CPT 96374: Rapid Intravenous Push Medication Administration

    CPT-96375-SEQUENTIAL-IV-PUSH-NEW-DRUG-ADD-ON

    CPT 96375: IV Push Sequential Drug Infusion (New Drug Add-On)

    Showing 1–10 of 15

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Description
    Relationship to This Procedure
    96372Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscularAlternative route of medication delivery when intra-arterial administration (96373) is not indicated or feasible; used for other routine injections in the same visit.
    96374Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance/drugIV route administration that may be used before or after intra-arterial therapy for systemic agents or sedation; documents IV push medications separate from intra-arterial 96373.
    99213Established patient office or other outpatient visit, typically 15 minutesRepresents a lower-level E/M visit that may be reported on the same day if a separately identifiable evaluation is performed in addition to 96373 (use 25 as applicable).
    99214Established patient office or other outpatient visit, typically 25 minutesRepresents a higher-level E/M visit that may be reported on the same day when a more complex, separately identifiable evaluation is performed in addition to 96373 (use 25 as applicable).